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PHM 114
Chapter 8
| Question | Answer |
|---|---|
| SSRIs | Selective Serotonin Reuptake Inhibitors. Used for depression. Also used for OCD,PMDD,anxiety,and panic disorder. Block serotonin reuptake into the presynaptic neuron |
| SNRIs | Serotonin-Norepinephrine Reuptake Inhibitors. Block reuptake of both serotonin and norepinephrine |
| TCAs | Tricyclic Antidepressants. Chemical structire, which contains 3 rings. Block reuptake of norepinephrine and/or serotonin. Also used for insomnia. Most widely prescribed class of antidepressants |
| MAOIs | Monoamine Oxidase Inhibitors. Last resort for intractable depression symptoms. Inhibit one of the primary enzymes that metabolizes neurotransmitters. Neurotransmitter levels rise in synaptic cleft |
| Benzodiazepine | For generalized anxiety disorder.Used for panic disorder,PTSD,preanesthetic medications to calm patients before surgery,alcohol withdrawal symptoms,and status epilepticus. Stimulate omega receptors in the CNS,causing drowsiness and relaxation |
| Sleep Aid | Shorter acting than benzodiazepines and do not cause as much leftover drowsiness the next day. Can be taken in the middle of the night if you frequently wake up |
| Typical Antipsychotic | Phenothiazines or Thioxanthenes. Block dopamine receptors that control emotion and thought. Laws and regulations govern the use of these in long-term care settings and limit giving them to patients who are simply wandering,calling out,or agitated |
| Atypical Antipsychotic | Some block dopamine and others enhance it. First line therapy for schizophrenia and other psychoses |
| Signs of Depression | Crying without reason,loss of interest in life or social activities,increased focus on death,and significant weight loss or gain |
| Symptoms of Depression | Low self esteem,pessimism,sleep disturbances,loss of energy and ability to think,feelings of worthlessness and guilt,confusion,poor memory,thoughts of suicide |
| Neurotransmitters involved in Depression | Norepinephrine,serotonin,dopamine |
| How long does it take for a patient to feel the affects of an antidepressant? | 3-6 weeks |
| How long should the drug trail last for depression? | 3-4 weeks |
| Should antidepressants be stopped adruptly? | No |
| What is the first line therapy for depression? | SSRIs and SNRIs |
| OCD | form of anxiety wherein obsessive thoughts intrude daily consciousness and impair function |
| PMDD | Emotional and behavioral changes in the second half of a woman's menstrual cycle |
| What is the side affect to the antidepressant Fluoxetine? | Can cause weight loss and is sometimes used for eating disorders, including bulimia |
| What are the cautions and considerations of SSRIs? | Increase the risk of serotonin syndrome |
| Serotonin Syndrome | Occurs when too much serotonin is present, causing changes in cardiovascular function and even heart attack. High risk if taking more than one antidepressant or while taking St.John's wort |
| What are the signs of Serotonin Syndrome? | Racing heart rate,fever,high blood pressure,and headache |
| What are the main side effects of TCAs? | DROWSINESS, anticholinergic effects, priapism |
| Priapism | Erection lasting longer than 4 hours |
| What are the main cautions and considerations of TCAs? | Cardiotoxicity, heart arrhythmias postural hypotension. They should not be taken with MAOIs because serotonin syndrome could develop |
| Washout | The time in between therapies if TCA is not working and an MAOI must be tried |
| What are the major side effects of MAOIs? | Heart palpitations, postural hypotension, anticholinergic effects |
| What are the major cautions and considerations of MAOIs? | Interact with numerous drugs. Interact with Tyramine |
| Bupropion | Blocks the reuptake of dopamine but also weakly blocks the reuptake of serotonin and norepinephrine. Used for smoking cessation and anxiety |
| Trazodone | May effect serotonin reuptake. Used with depression with insomnia because its predominant side effect is drowsiness. Used for neuralgic pain and anxiety that affects sleep |
| Anxiety | Abnormal function of the neurotransmitters that regulate brain activity,mood,and fear response. Serotonin and norepinephrine also involved |
| Panic Disorder | Symptoms such as chest pain,difficulty breathing,palpitations,dizziness,sweating,a choking sensation,trembling,and unrealistic feelings of doom |
| When is a diagnosis for panic disorder made? | If you have at least 3 panic attacks in three weeks |
| Generalized Anxiety Disorder | Excessive worry that causes significant distress or disturbance to work or social functioning and that continues for at least 6 months |
| Post-traumatic Stress Disorder | PTSD. Variation of anxiety. Prevalent with military personnel returning from combat zones. Traumatic event after which a reexperiencing syndrome continues for at least a month |
| What are the symptoms of PTSD? | avoiding thoughts,conversations,activities,people,or places they would normally enjoy. Counseling and drug therapy is the treatment |
| Hypnotic | term for medication that causes sedation and relaxation |
| Sedatives | Used to induce sleep. Another word for Hypnotic. Used for short term treatment |
| What drug class is a controlled substance schedule IV? | Benzodiazepines |
| Buspirone | Antianxiety medication. Blockes serotonin receptors in brain. Not a controlled substance. Does not cause Euphoria |
| What is the main caution and considerations for Buspirone? | They interact with MAOIs |
| Insomnia | Inability to fall asleep and stay asleep. Symptom of depression,anxiety,and other mental disorders. Usually a reaction to stressful situation and simply a disruption in normal sleep cycle |
| What other medical conditions can cause Insomnia? | Obstructive sleep apnea,restless legs syndrome, and narcolepsy. |
| How should drug therapy be used for insomnia? | Used as last resort and only for short term |
| What is the first drug therapy option for insomnia? | OTC antihistamines such as Diphenhydramine and Hydrixyzine which cause drowsiness. TCAs are also used if it accompanies depression |
| Nonpharmacologic Therapy for insomnia | Setting consistent time to go to bed and wake,using bedroom only for sleep,increase physical activity,decrease aclcohol,cigarette,and caffeine consumption. Should work within 2 weeks |
| Ramelteon | Sleep aid that is a selective melatonin agonist that works by mimicking melatonin |
| What are Eszopiclone,Zaleplon,and Zolpidem? | Sleep aids exclusively for insomnia. Shorter acting and do not cause as much leftover drowsiness. Can be taken in middle of night |
| Main side effects of Sleep aids? | Swelling of the face,tongue,and difficulty breathing. |
| Main Cautions and considerations of sleep aids? | Eszopiclone,Zaleplon,and Zolpidem are controlled substances. Be prescribed for 2 weeks or less. Ramelteon is not controlled substance. Dont take with high fat meals. Interacts with other prescription drugs that are metabolized through the liver |
| Bipolar disorder | Dysfunction of neurotransmitters such as GABA,serotonin,and norepinephrine. Periods of depression with times of mania |
| What is the main drug therapy used for bipolar disorder? | LITHIUM. anticonvulsants such as cabamazepine,lamotrigine,and valproic acid is also used. Atypical antipsychotic agents are also used. |
| What is Lithiums important action? | its a mood stabilizer |
| What is the main side effect of Bipolar? | Weight gain,hypothyroidism,heart arrhythmias,and leukocytosis |
| Schizophrenia | Comprosed of positive symptoms(hallucinations and delusions) and negative symptoms(withdrawal,memory loss,confusion). Imbalance of various neurotransmitters |
| What does treatment do for Schizophrenia patients? | maintains normal thought and function |
| Reactive psychosis | occurs briefly lasting form only a few hours to just under a month then subsides |
| Delusional disorder | delusional thoughts that last longer than a month but do not impair normal function |
| Schizophreniform disorder | Symptoms similar to those of schizophrenia but occur for less than 6 months |
| How is drug therapy for schizophrenia and psychosis adjusted? | slowly increased over weeks to months and then adjusted to achieve a balance between the control of symptoms and minimal side effects |
| What drug therapy for schizophrenia is used first? | Atypical agents |
| What is Haloperidol also used for? | Tourettes syndrome |
| What is Prochlorperazine also used for? | Used in low doses for nausea and vomiting |
| What are the main side effects of typical antiphyschotics? | EPS side effects and tardive dyskinesia |
| Extrapyramidal symptoms | EPS. Tremors,muscular rigidity,difficulty initiating movement |
| Tardive Dyskinesia | Uncontrollable tongue thrusting and lip smacking |
| What are the main cautions and considerations of typical antipyschotic agents? | arrhythmias and alterations in heart function called QT wave prolongation |
| What are the main side effects of atypical antipsychotic agents? | EPS side effects. Quetiapine increases risk of cataracts. High cholesterol levels and new onset diabetes. arrhythmias and QT wave prolongation |
| What are the cautions and considerations of atypical antipsychotic agents? | Can cause bone marrow suppression. CLozapine is associated with severe blood disorders affecting blood cell growth and development |
| Melatonin | Used for variety of sleep and insomnia disorders as well as for benzodiazepine and nicotine withdrawal.Never take with CNS depressants |
| Kava | used for anxiety and insomnia. Work by affecting GABA and dopamine in the brain |
| St.John's Wort | Taken orally for mild depression with some success. Relieves the psychological symptoms of menopause and used with black cohosh(remifemin) Active ingredient is hypercin. Dont take with CNS depressants,digoxin,phenytoin,or phenobarbital |
| SAMe | Used for mild depression and osteoarthritis and fibromyalgia. Produced naturally in the body and supports neurotransmitter formation. Never take with other antidepressants |
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Tara3184
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